Evan Harris, LCSW, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.019633 Issued in IL

Practice address

100 19TH St Ste 102
Rock Island, IL 61201-8022

Phone

(309) 236-9553

NPI assigned

Dec 15, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tapas Yoga Shala

  • Clinical Social Worker
  • Rock Island, IL
  • NPI 1629584511
  NPD Authorized official
• Healing Hands Chiropractic

  • Chiropractor
  • Bettendorf, IA
  • NPI 1982276440
  NPD
• The Healing Heart Center, Inc.

  • Clinical Social Worker
  • Bettendorf, IA
  • NPI 1235368721
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1194231019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51",
            "city": "PREEMPTION",
            "state": "IL",
            "postal_code": "612760051",
            "telephone_number": "309-236-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 19TH ST STE 102",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612018022",
            "telephone_number": "309-236-9553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 Eastern Ave Bldg G",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528032012",
            "country_code": "US",
            "telephone_number": "309-236-9553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "EVAN",
        "credential": "LCSW, LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "008410",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syed M Haque, M.D.
• Hari Babu MD SC
• Harmony Chiropractic Arts Inc
• Gaylene Elaine Harrell
• Charles Mickel Harris
• Lynn Anne Harris
• David Hartsuch, MD
• Stacie Meri Hatfield, ED.D., CCC-SLP
• Betty Hatley
• Haven Chiropractic, PLLC

• Clinical Social Worker in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.